SFY 2021 - 2022 MC MLR Summary
Medicaid Advantage (MA) line of business
| SFY 2021 - 2022 MC MLR Summary | ||||||||
|---|---|---|---|---|---|---|---|---|
| Medicaid Advantage (MA) line of business | ||||||||
| Plan | MLR AFTER Credibility Adjustment |
Medical Expense (Total Numerator) |
Premium [Used for MLR%] (Total Denominator) |
Medicaid Only Premium [Used For Remittance] |
Remittance | Credible | MMs | |
| New York Quality Healthcare Corporation (Fidelis Care) | 93.26% | $22,259,125 | $25,401,817 | $1,483,878 | $0 | Partially Credible | 12,462 | |
| United Healthcare of New York, Inc. | 75.71% | $13,713,009 | $19,501,458 | $1,397,497 | $143,802 | Partially Credible | 14,192 | |
| WellCare of New York, Inc. | 121.02% | $14,604,685 | $12,727,946 | $791,244 | $0 | Partially Credible | 10,610 | |
| Total | $50,576,819 | $57,631,221 | $3,672,620 | $143,802 | 37,264 | |||
NOTES:
Please note that the Remittance is for this line of business for one year ONLY based on a MLR Target of 86%.
The MLR% calculation for the Medicaid/Medicare integrated lines of business includes both the Medicare and Medicaid experience.
Remittances, if applicable, are calculated by multiplying the MLR% by the Medicaid Only Premium.
No remittance for plan if Non-Credible
